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Jean K. Kammerer, BSN, RN, CNN

Jean K. Kammerer, BSN, RN, CNN, is Senior Manager, Nephrology Medical Communications, Amgen, Inc., Thousand Oaks, CA. She is a member of ANNA’s Chumash Chapter. For more information on this article, contact the author at jeankam merer@gmail.com.

Glenn Garry, BS

Glenn Garry, BS, is Senior Marketing Manager for Amgen, Inc., retail and specialty pharmacy adherence programs for Sensipar®, Thousand Oaks, CA.

Marguerite Hartigan, MSN, RN

Marguerite Hartigan, MSN, RN, is Nephrology Nurse Practitioner and Senior Manager, Aranesp® Medical Communications, Amgen, Inc., Thousand Oaks, CA. She is a member of ANNA’s Chumash Chapter.

Barbara Carter, MEd, BSN, RN, CNN

Barbara Carter, MEd, BSN, RN, CNN, is Clinical Educator, NxStage Medical, Inc., and was Senior Manager, Nephrology Medical Affairs, Amgen, Inc., Thousand Oaks, CA at the time this article was prepared. She is a member of ANNA’s Chumash Chapter.

Linda Erlich MS, RN

Linda Erlich MS, RN, is Clinical Consultant and Educator in Nephrology, Rancho Santa Fe, CA. Association (ANNA).

Adherence is a major problem in patients with chronic kidney disease. Patients can be nonadherent with different aspects of their treatment, which includes medications, treatment regimens, and dietary and fluid restrictions. Although many lessons have been learned from adherence research, the evidence of how to modify adherence is somewhat mixed. To minimize nonadherence, interventions need to focus on both patient factors and the extent to which relationships and system problems compromise the patient’s ability to adhere to medication and treatment plans. There continues to be a tendency to focus on the patient as the reason for problems with adherence, ignoring other factors such as the patient-health care provider relationships and the health care system that surrounds the patient. These latter factors can have a considerable effect on adherence. The nurse can develop a strong relationship of support with the patient, identify barriers, and offer strategies to help patients improve adherence.